Ectropian (or turned out eyelid) and Entropian (or turned in eyelid) surgery aims to restore the malposition of the eyelid, provide adequate protection to the eye as well as achieving a good cosmetic appearance.

To make an appointment, call 01925 215068

For treatment enquires please call Jane 01925 215029

Ectropian and Endropian Surgery

What is Ectropian?

Ectropian describes the outward turning of the lower eyelid and lashes away from the eye and is usually caused by relaxation of the eyelid muscles as a result of ageing. This can lead to excess watering an impaired vision, pain, crusting of the eyelid, discharge and a feeling that something is in the eye.

Following surgery, it is normal for eyelids to appear swollen, red or bruised. Antibiotic ointment will be prescribed for use four times a day for one week and this can often make vision blurred for around five minutes after application.

What happens at surgery?

A combination of the techniques below are used to restore the eyelid to its normal position.

Inverting Sutures (Medial Spindle)

One stitch is placed in the lower eyelid on the nasal side to return the eyelid to a normal position, and prevent further eye damage. This is a dissolvable suture which only occasionally needs removing.
Lower Eyelid Surgery

If the lower eyelid is ‘loose’, this can be the main reason why the eyelid turns in. This is corrected by tightening the lower eyelid. A lax retractor tendon can also be tightened to improve eyelid stability. Depending on the technique used sutures may need to be removed.

Skin Graft

In occasional cases insufficient skin in the lower eyelid may be the main cause of an ectropion. In these circumstances, extra skin is placed below the lashes to return the lid to the normal position. The skin is taken from the upper eyelid, in front of or behind the ear, or from the inner arm.

This procedure is performed under a local anaesthetic as a day case treatment, so that patients can return home shortly after the procedure has been completed.

What to expect after surgery?

For one week after surgery, the eye area should be cleaned using cooled, boiled water and cotton wool twice each day. A repeat visit will be arranged and stitches may need to be removed.

What are the risks and side effects of surgery?

There are some small risks associated with surgery and these include:

Bruising from the injection

Scarring of the eyelid

Infection

Over correction

Recurrence of the ectropion

Occasionally patients may be intolerant of the antibiotic ointment prescribed following the procedure, and this can cause itching, redness and swelling. In such circumstances, the nurse should be informed straight away, who can arrange for an alternative treatment to be provided.

What is Entropion?

Entropian is used to describe the inward turning of the lower eyelid and lashes towards the eye and is usually caused by relaxation of the eyelid muscles as a result of ageing. This causes the skin of the eyelid and eyelashes to rub against the eye, which can lead to excess watering and impaired vision, pain, crusting of the eyelid, discharge and a feeling that something is in the eye.

Following surgery, it is normal for eyelids to appear slightly swollen, red or bruised. Antibiotic ointment will be prescribed for use four times a day for one week and this can often make vision blurred for around five minutes after application.

What happens at surgery?

A combination of techniques are used to restore the eyelid to its normal position.

Everting Sutures

Two or three dissolvable stitches are placed in the lower lid to return the eyelid to a normal position and prevent any further eye damage.

Lower Eyelid Surgery

If the lower eyelid is ‘ loose’, this can be the main reason why the eyelid turns in. This is corrected by tightening the lower eyelid. A lax retractor tendon can also be tightened to improve eyelid stability. Depending on the technique used sutures may need to be removed.

This procedure is performed under a local anaesthetic as a day case treatment, so that patients can return home shortly after the procedure has been completed.

What to expect after surgery?

For one week after surgery, the eye area should be cleaned using cooled, boiled water and cotton wool twice each day. A repeat visit will be arranged with the Nurse Practitioner and stitches may need to be removed.

What are the risks and side effects of surgery?

There are some small risks associated with surgery and these include:

Bruising from the injection

Scarring of the eyelid

Infection

Over correction

Recurrence of the entropion

Occasionally patients may be intolerant of the antibiotic ointment prescribed following the procedure, and this can cause itching, redness and swelling. In such circumstances, the nurse should be informed straight away, who can arrange for an alternative treatment to be provided.